Final Behavioral Health Parity Rules Submitted to White House for Last-Stop Review

The U.S. Department of Labor has submitted its final rule that overhauls parity regulations for a final review at the White House, a last stop before its public release.

It’s not clear when the rule will be released. If published as previously proposed, the new rule would revamp provisions implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) and establish new regulations regarding non-quantitative treatment limitations (NQTL) requirements. It would also impact the composition of the health plan network.

The Department of Labor submitted the rule to the Office of Management and Budget (OMB) on July 1. The Centers for Medicare & Medicaid Services and the Internal Revenue Service also participated in establishing this rule. 


“The Departments are proposing these revised rules to reinforce MHPAEA’s fundamental objective, to ensure that limitations on mental health and substance use disorder benefits are no more restrictive than the limitations applicable to medical/surgical benefits,” the proposed rule, initially released in July 2023, states.

Since the rule has been deemed “significant,” it will be required to have a 60-day-long delay on its effective date. 

The proposed rules would incorporate provisions from several laws passed by Congress as well as the experience of several federal agencies since the last major overhaul of mental health parity rules in 2014.


Behavioral health advocates reacted strongly to the rule when it was proposed and under public comment.

“Too often, arbitrary barriers prevent people from getting the mental health and substance use treatment and care they need,” National Council for Mental Wellbeing President and CEO Chuck Ingoglia said at that time.

Payer groups oppose the rules, calling them too vague and too burdensome.

Parity remains the top unresolved behavioral health regulatory question of the first term of the Biden administration. It has been an issue for nearly 30 years with the passage of the The Mental Health Parity Act of 1996

The other major hot button behavioral health topic is how the Drug Enforcement Administration will handle regulations for telehealth and prescribing controlled substances now that COVID-era regulatory flexibilities have lapsed.

Earlier in the month, the DEA submitted another proposed rule to OMB in mid-June on the matter after releasing its first proposed rules in March 2023.

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